Screenings may give sense of security, but experts say they can be duped

Below:

What Maryellen Stratmann heard at her youngest son’s freshman orientation a few weeks ago was music to the Springfield, Mo., mother’s ears: His Catholic high school would be conducting random drug testing on all students.

Her older son also has random drug testing at his public high school, but only for kids who participate in extracurricular activities. To Stratmann and her husband — both physicians who have worked in ERs and witnessed firsthand the effects of drug overdoses and other drug-related problems — the more testing the better.

“It might help identify a teen who needs help,” she reasons. “We also think it makes the campus a safer place, since drugs can interfere with an individual's ability to make good decisions.”

After two Supreme Court decisions upholding the constitutionality of random drug testing and an increase in funding by the Bush Administration to administer the urine tests, more schools across the nation are starting to consider this a feasible method to convey an anti-drug message. Many private schools are testing entire student bodies, and numerous public schools are testing students involved in extracurricular activities (e.g., sports, yearbook committees or even to obtain a parking pass).

Last year, a survey of superintendents by University of New Hampshire researchers published in the journal Education Law Reporter found that about 12 percent of school districts nationwide now drug test students. An additional 10 percent were considering adopting such policies. Parents can opt out, of course, but that means either their child won’t be able to attend the private school or won’t be allowed to participate in the public-school extracurriculars.

Yet, despite the growing popularity, many experts have misgivings.

“I’m a firm believer kids shouldn’t be using drugs, but I don’t think drug testing is giving people the information they think it is,” says Dr. Sharon Levy, director of the Adolescent Substance Abuse Program at Children’s Hospital Boston. “I hear people talk about drug testing as if it’s a pregnancy test. People think it’s the simplest thing — pee in a cup and run the test and it says yes or no.”

Drug tests are typically administered by contracted medical professionals who randomly select students from a database and come on campus the day of testing. Children are called out of class and asked to give a urine sample. They may be escorted to the nurse’s office, for example, but the students are allowed privacy while giving the sample. The parents, students and school officials are notified of the results of the test. If the sample indicates a child is using, in most cases the student is referred for counseling. Extracurricular activities and privileges are usually revoked.

Levy explains, however, that testing for drugs is complex and there are many limitations. For example, if someone is using a drug not being tested for by the panel, the test will come up negative. If it’s been 48 to 72 hours since the student last used, the test will likely come up drug-free. And if the specimen is adulterated, the test will not be able to detect drugs. Furthermore, prescription drugs interfere with tests.

“Just drinking two half-liter bottles of plain water will dilute the urine so much that it’ll drive detection of substances below detection level,” says Levy.

False sense of securitySome parents warn that the results of drug tests are in fact so untrustworthy that they fear others will actually gain a false sense of security from knowing their schools test.

Judith Kirkwood, a Fitchburg, Wis., mother says she knows from experience that drug tests are far from reliable. Her son, who is now 19 and sober, started doing drugs in middle school. “My son was using marijuana regularly by eighth grade and went on to cocaine, crack and heroin,” says Kirkwood, who is a member of the Parent Advisory Board of Partnership for a Drug-Free America and blogs about adolescent drug use at www.motherwarriors.blogspot.com. Throughout his drug use, Kirkwood says her son was being randomly tested to little avail.

“I know my son was able to use other kids’ urine for random drug screens at a credentialed medical lab. You literally have to have your eyes glued to kids’ private areas in order to ensure a clean screen, and I just don’t think our schools are equipped to perform the tests or that parents would accept that kind of scrutiny, and they shouldn't,” says Kirkwood.

She contends that as random drug testing in schools grows, so will the black market for ways to fool the test. Clean urine samples and masking products with names such as UrinAid, THC Free and Instant Clean are already available.

Moreover, Levy says she worries about drug testing as a child-rearing strategy.

“What I know about adolescent development and behavior is that drug testing is a threat, and threats work a bit, but not in the long term,” she says. “We don’t recommend you threaten your kids to get them to not do things.”

Surprisingly, preliminary research by Levy and colleagues indicates that drug testing is so susceptible to both tampering and misinterpretation, even in the hands of reputable medical professionals, that merely talking to kids would likely garner more information — and more accurate information — than random drug testing.

“The people asking the questions need to have training but … kids do answer these questions. There’s no doubt. Will everyone tell the truth? Of course not,” says Levy. “But when you sort of give it over to drug testing and say, ‘Now, I want to see a negative test,’ they’ll find a way to give you a negative test.”

Leading experts on adolescent drug use bring up another disconcerting issue: There are comprehensive education and outreach programs that have scientific studies indicating that kids who go through them do fewer drugs, but there is no scientific evidence that suggests random drug testing has a similar impact. In fact, the Substance Abuse and Mental Health Services Administration maintains the National Registry of Evidence-based Programs and Practices, a database of proven drug-prevention programs. Random drug testing is not included in this database.

Dr. Linn Goldberg, a researcher at Oregon Health and Science University, likens testing to a doctor prescribing an experimental blood pressure medication instead of one that has been proven effective. He and other drug abuse experts say that the message that drug prevention is evidence-based and certain programs work has not been heard. Instead, billions of dollars have been squandered on programs without scientific merit that do not work (e.g., D.A.R.E., the Just Say No ad campaign and, possibly, random drug testing).

Proponents on both sides are undoubtedly well intended, but we may soon have a long awaited piece of evidence to give credence to one group. Goldberg says his team is crunching the data collected from a two-year randomized controlled study of schools with and without random drug testing. He’s now preparing for publication.

Don Stewart, superintendent of Penn Manor School District in Lancaster County, Penn., believes there’s no time to waste. “I like [drug testing] because it says we are willing to do all it can to prevent kids from throwing away their lives with drug use.”

His district is in its second year of random testing, and for now, anecdotal evidence is enough for him. Last year, with random drug testing in place, Stewart says only about one-third the number of students were referred for drug-related judicial review compared to the previous year in his district. “I’m not saying we’ll see the same thing this year or that there’s necessarily a cause and effect relationship,” he admits. “I don’t have empirical data. Still, implementing drug testing speaks to what our community stands for. We don’t turn our backs on a problem.”

The youngest Stratmann boy agrees. As long as the testing is done with an emphasis on helping kids and their families, says 14-year-old Joe, why not?

Victoria Clayton is a freelance writer based in California and co-author of "Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom," published by Fair Winds Press.